Rowell综合征一例

<正>临床资料患者,女,22岁。因全身红斑、丘疹伴瘙痒1周,于2016年4月8日入院。1周前,无任何诱因患者双手出现散在黄豆大红斑、丘疹,伴轻微瘙痒,未治疗。皮损迅速增多,延及全身,以面部为著,日晒后皮损加重。1 d前出现低热,未治疗。患者自起病以来,同时出现口腔溃疡,无脱发、关节疼痛等表现。既往史:1个月前,全身曾出现类似皮损,至当地医院治疗     

慢性淋巴细胞白血病相关副肿瘤性天疱疮1例

<正>患者男,69岁。全身红斑、丘疹伴口腔溃疡2个月,于2020年6月来我院皮肤科就诊。患者于2020年4月无明显诱因出现全身红斑、丘疹伴口腔溃疡,外用糖皮质激素（具体不详）对症治疗后红斑消退,口腔溃疡无明显好转。2020年5月初出现双侧眼睑下垂,至长海医院神经内科就诊,新斯的明试验阳性,诊断肌无力,给予肌注甲硫酸新斯的明、硫酸阿托品治疗（具体用量不详）,     

类天疱疮样扁平苔藓1例

临床资料患者女,46岁。口腔溃疡7个月,全身丘疹伴瘙痒3个月。患者7个月前无明显诱因口腔黏膜出现水疱,疱液清,进食时容易破溃,伴有明显疼痛,当地医院给予外用药物漱口（具体药物不详）,未见明显好转。3个月前先于躯干出现粟粒至黄豆大红色丘疹、斑丘疹、丘疱疹,皮损逐渐增多,发展至全身,自觉瘙痒剧烈,无发热及关节痛。我科门诊拟“扁平苔藓”行皮肤病理检查及天疱疮抗体测定,并收入院。起病以来,因口腔内水疱破溃引起疼痛进而进食少,半年来体重下降约5kg。患者平素体健,无肝炎、结核病病史,无药物及食物过敏史,家族中无类似病例。     

副肿瘤性天疱疮1例

<正>患者女,62岁。因口腔溃疡4个月,全身紫红色斑丘疹1周于2007年8月15日就诊于我科门诊,门诊拟诊"扁平苔藓?副肿瘤性天疱疮?"收住院。患者4个月前无明显诱因下出现口腔破溃,伴明显疼痛,当地医院给予消炎等对症处理没有好转,且进行性加重。近1周全身皮肤逐渐出现紫红色斑丘疹,伴剧烈瘙痒。     

大疱性类天疱疮1例

患者男,64岁.双下肢出现丘疹伴瘙痒3个月,全身起水疱1个月.患者3个月前无明显诱因双下肢出现红色丘疹,渐增多并融合成片,瘙痒剧烈,曾就诊于多家医院,多按"湿疹"给予治疗,效果欠佳,皮损渐加重.     

副肿瘤性天疱疮1例

患者男,45岁。因口腔溃疡5个月,全身红斑、丘疹及鳞屑2个月,加重1个月,于2007年2月收治入院。患者2006年9月开始出现口腔溃疡及疼痛,12月起胸部及背部出现红色丘疹,不断增多、融合,并有脱屑,蔓延到四肢,皮损逐渐融合成大的斑块,面颈部出现斑丘疹,肛周、包皮及龟头糜烂。     

长期外用和口服糖皮质激素继发皮肤脂肪疝一例

患者男,72岁,因全身红斑丘疹伴瘙痒5年、加重1个月,颈部及左上肢屈侧淡黄色结节半年入院。患者入院前5年无明显诱因全身出现散在红斑、丘疹,伴瘙痒,于本院门诊诊断为慢性湿疹,予抗组胺药等对症治疗,病情间断缓解,反复发作……     

急性泛发性扁平苔藓一例

忠昔，男，40岁，主刚双下肢红色丘疹3个月，泛发全身7d，于2011年4月15日就诊。3个月前无明显诱因患者小腿伸侧对称性出现3～5个绿豆大小紫红色丘疹伴瘙痒，夜间较重。     

伴急性苔藓痘疮样糠疹皮损的急性髓系白血病一例

患者男,61岁。全身出血性丘疹、伴痒2个月,于2012年1月5日来院就诊。患者2个月前先于鼻周、额头出现散在半球形红色丘疹,逐渐融合,伴少许脱屑、瘙痒,皮损中央出现脓疱,当地诊所给予抗过敏治疗（具体不详）,皮损进行性增多,累及躯干部,瘙痒加重,部分丘疹出现出血、坏死及结痂;1个月前再次于当地医院就诊,给予外用药物治疗（具体不详）,皮损逐渐增多增大,坏死性皮损明显增多……     

发生于毛囊的银屑病1例

1病历摘要 患者男,20岁.因双上肢反复出现鳞屑性红斑、丘疹,伴瘙痒6个月余,泛发全身2个月余入院.6个月前患者双肘部出现绿豆大丘疹,上覆鳞屑,伴瘙痒.2个月前皮损渐发至全身,部分融合.     

New fillers for the new man

ABSTRACT:  Two new collagen-based lidocaine-containing dermal fillers, ArteSense™/ArteFill™ (Artes Medical, San Diego, CA) and Evolence® (Colbar LifeScience Ltd., Herzliya, Israel), have proved to be of particular interest to men, many of whom seek a long-lasting or permanent correction. ArteFill™ has been available in the United States since 2006, and it is expected that Evolence® will reach the American market in 2008. The properties of the two products will be described, and experience based on the administration of many hundreds of syringes of both products by a Canadian dermatologist will be detailed here, with tips and precautions to optimize patient outcomes.     

Outcomes and adverse effects of ablative vs nonablative lasers for skin resurfacing: A systematic review of 1093 patients

It is generally believed that ablative laser therapies result in prolonged healing and greater adverse events when compared with nonablative lasers for skin resurfacing. To evaluate the efficacy of ablative laser use for skin resurfacing and adverse events as a consequence of treatment in comparison to other modalities, a PRISMA‐compliant systematic review (Systematic Review Registration Number: 204016) of twelve electronic databases was conducted for the terms “ablative laser” and “skin resurfacing” from March 2002 until July 2020. Studies included meta‐analyses, randomized control trials, cohort studies, and case reports to facilitate evaluation of the data. All articles were evaluated for bias. The search strategy produced 34 studies. Of 1093 patients included in the studies of interest, adverse events were reported in a total of 106 patients (9.7%). Higher rates of adverse events were described in nonablative therapies (12.2% ± 2.19%, 31 events) when compared with ablative therapy (8.28% ± 2.46%, 81 events). 147 patients (13.4%) reported no side effects, 68 (6.22%) reported expected, transient self‐resolving events, and five (0.046%) presented with hypertrophic scarring. Excluding transient events, ablative lasers had fewer complications overall when compared with nonablative lasers (2.56% ± 2.19% vs 7.48% ± 3.29%). This systematic review suggests ablative laser use for skin resurfacing is a safe and effective modality to treat a range of pathologies from photodamage and acne scars to hidradenitis suppurativa and posttraumatic scarring from basal cell carcinoma excision. Further studies are needed, but these results suggest that ablative lasers are a superior, safe, and effective modality to treat damaged skin.     

Genetic alterations in RAS‐regulated pathway in acral lentiginous melanoma

Studies integrating clinicopathological and genetic features have revealed distinct patterns of genomic aberrations in Melanoma. Distributions of BRAF or NRAS mutations and gains of several oncogenes differ among melanoma subgroups, while 9p21 deletions are found in all melanoma subtypes. In the study, status of genes involved in cell cycle progression and apoptosis was evaluated in a panel of 17 frozen primary acral melanomas. NRAS mutations were found in 17% of the tumors. In contrast, BRAF mutations were not found. Gains of AURKA gene (20q13.3) were detected in 37.5% of samples, gains of CCND1 gene (11q13) or TERT gene (5p15.33) in 31.2% and gains of NRAS gene (1p13.2) in 25%. Alterations in 9p21 were identified in 69% of tumors. Gains of 11q13 and 20q13 were mutually exclusive, and 1p13.2 gain was associated with 5p15.33. Our findings showed that alterations in RAS‐related pathways are present in 87.5% of acral lentiginous melanomas.     

Self‐resolving superficial primary cutaneous mucormycosis in a 7‐week‐old infant

A 7‐week‐old girl, born at 30 weeks' gestational age, presented to clinic for evaluation of a crop of vesicular lesions that were noted after removal of a bandage that had been in place for 4 days. A punch biopsy of the lesion revealed fungal elements that were later identified as Rhizopus spp. The lesion began to self‐resolve, and no further treatment was needed, with full resolution of the lesion by 1 month after presentation. Clinicians should be aware of the variable presentations of mucormycosis and consider fungal infection in the differential diagnosis when evaluating vulnerable patients with skin eruptions.     

Pathogenic role of IL-17 in psoriasis and psoriatic arthritis

Psoriasis is a chronic inflammatory skin disorder resulting from a complex network of cytokines and chemokines produced by various immune cell types and tissue cells. Emerging evidence suggests a central role of IL-17 and IL-23/T17 axis in the pathogenesis of psoriasis, giving a rationale for using IL-17-blocking agents as therapeutics.Three agents targeting IL-17 signaling are being studied in Phase III clinical trials: secukinumab and ixekizumab (IL-17 neutralizing agents), and brodalumab (IL-17 receptor antagonist). Preliminary results are highly promising for all anti-IL17 agents, creating fair expectations on this class of agents as the new effective therapeutic approach for the treatment of psoriasis.